Dropping supplements to EBF - possible?

[ASheepLessOrdinary]

Our DD is now just over 8 weeks old. At 10 days, her birth weight had dropped by 12.5% and we were told by the midwives and a paediatrician to give her formula top-ups.

For over 6 weeks, we were on a schedule of breastfeeding + bottle top-up + pumping every 3 hours (+ on-demand feeding inbetween if she was hungry earlier than the 3 hours). However, until last week DD was still very slow to gain weight. Our HV then told us to increase the amount of top-ups and last week, DD gained nearly 300g, which puts her back just over the 2nd percentile (she is tiny, although DP and I were quite small at birth and both still struggle to put on weight as adults).

Given this weight gain, the HV then suggested dropping a few feeds and only waking DD if she goes for longer than 5 hours, rather than a strict 3-hour schedule (which was close to giving us a breakdown!). We are now doing 6 top-ups a day but offering a bit more in case she is still hungry. The amount of supplement she is taking has dropped quite a bit over the last few days, but usually it's because she isn't finishing a whole bottle.

I would really like to get be able to EBF - does anyone have any success stories or tips on whether this can be achieved at this time?

The plan is to slowly reduce her top-up amount by one or two ounces every few days, to monitor her nappy output and give my boobs a chance to catch up. I am obviously worried that she will go back to not gaining weight properly and I am not sure we can rely on our HV to have the expertise to deal with this.

[SpeakNoWords]

I've been in the position where I've been supplementing with EBM/formula top ups and moved back to exclusively breastfeeding. I've done this with DS1 and now DS2, similar situation for both where they were in SCBU after birth and tube fed initially.

It is hard work, and when you drop the top ups you will need to be prepared to feed often as they will need to build up your supply. It can seem like you're always trying to catch up with them but you can get there in the end. My HV was happy to continue with top ups and had no advice on how to drop them, so I worked out a plan myself, much as you've done.

[ispymincepie]

My advice would be not to focus on the weight but rather her output, whether she settles etc.... I too would not think the HV would give reliable information. I probably wouldn't even weigh her unless you're worried. My ds2 was very slow to gain weight but was still perfectly healthy.

[ASheepLessOrdinary]

Thank you both, I'm amazed Speak that you have managed this twice!

The weird thing is that her output has always been good and whenever she was seen by HV/MW/Hospital, they commented on how alert she is. She never really seems hungry or unsettled, it's more like she takes the bottle just because it's there. The only issue is her lack of weight gain / being tiny.

Part of the problem is that I've had so much pressure from the various HCPs that I am really paranoid about doing the wrong thing and finding it difficult to trust my instincts now. It's getting better as we have made quite good progress in reducing her top up quantity this week by a quarter, and weirdly she isn't actually spending much more time feeding so far. With her being our first DC, it's easy to forget that we don't HAVE to follow everything the HV says.